Student Name:
Semester & Year:
Department of Chemistry
Directed Studies Authorization Form
JAG Number:
Course Number:
Credit Hours:
CRN (office use only):
In the space provided, please indicate the general subject matter in which you will be exploring throughout the course of
your research, as well as a succinct description of the project.
Topic: _____________________________________________________________________________________________
Description:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
I request to take Directed Studies, a course that requires independent laboratory research under faculty guidance. I
understand that it is my responsibility to consult with my faculty mentor promptly and frequently to insure that all
necessary work is completed on time and in a professional manner. I also understand that at the completion of this
course, a written report is due to my faculty mentor for grading, as well as the Chemistry Department Secretary for
verification purposes. (If you are a CH394/494 or 2nd term CH 499 student, please indicate when your report will be
turned in, at the discretion of the mentor, a report does not have to be furnished for 1st tem CH 499 students.)
My report is due
.
I am a first Term CH 499 student and will not turn in a report.
While this experience may be repeated, the sum of 394 and 494 cannot exceed eight (8) hours.* Please list all previous
394/494 experiences below by term and credit hours.
Student Signature
Date
Jagmail
@jagmail.southalabama.edu
For office use only
I agree to direct this student’s work, monitor progress towards goal(s) set above, evaluate report(s) submitted, and
assign a grade at the course’s conclusion.
Faculty Signature
Date
Department Chair Signature
Date
Date Completed:
Grade Recorded: ________
*An excess of eight (8) hours will impact student status as it relates to credit hours, quality points, and financial aid.